1. Background Small-scale multifunctional long-term care for the elderly, or takurousho, started in Japan in the mid-1980s, and expanded nationwide during the 1990s. In takurousho, both institutional and non-institutional services, including visitation, overnight stays, and long-term stays, are offered. In 2006, a new institutional service offering “multifunctional long-term care in a small group home” was started to support in-home living for the elderly requiring substantial amounts of care. This service was originally centered on providing services for the elderly who commuted to a day care facility; however, based on individual needs and the wishes of those requiring long-term care, visitation and overnight stays, but not long-term stays, were offered. To date, no studies have investigated the use of multifunctional long-term care services and the architectural space in day care facilities. 2. Purpose The purpose of this study was to clarify both the actual use of multifunctional long-term care services and the architectural space in a small pioneering care facility. We focused on the following two issues: the actual use of multifunctional services and the use of the architectural space in the facility. 3. Research Methods We selected Takurousho Y, a pioneering care facility in Fukuoka, Japan, as the target of this study. We collected the records of all the elderly who used the facility over a 20-year period from 1995 to 2015, and discussed these elderly records with the care staff. We also carried out observational research at the facility in 2002, 2003, and 2015, and conducted interviews with four users' families in 2005. 4. Results We found that over 30% of users who attended the facility for less than 1 year made use of only a single service, whereas those who used it for 2 years or more made use of multiple services. This finding suggests that patients who make use of multiple services tend to be more stable long-term users. In addition, the long-term users who felt a sense of stability tended to want to stay longer and be looked after by the same staff. In fact, about 10% of the long-term stay users died in the facility, which thereby served as their “final home.” When the families of the users needed to make abrupt changes in the care services the users were receiving, the care staff conducted interviews and made the corresponding changes in the type or frequency of the service. Furthermore, no differences were found between the old facility (2002) and the new facility (2015) in the actual use of the architectural space; the layout and usage of the rooms in each facility were similar. The short- and long-term stay users interacted with day care users in one living room during the day, and then spent time in a different living room closer to the bedrooms at night. This spatial separation between the public and private zones provided a sense of stability and security to the users. Finally, Takurousho Y does not follow a daily schedule or organize group activities. Care and activities are offered based on requests from the users. Therefore, the living rooms had movable furniture for flexible use of the space, allowing users to spend their time according to their own interests. In conclusion, we note that long-term stays were one of the important multifunctional care services provided based on requests from the elderly users and their families in Takurousyo Y, and the space had been set up to adapt the care accordingly.
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Apr 1, 2021
Nicole De Aquino + 2
Open Access
